Mixing Studies 24/7?

From Kim Kinney, IU Health in Indianapolis: We offer mixing studies all shifts, 24/7. If not ordered STAT, we call the floor and ask if it can be set up the next day. Do other institutions run mixes 24/7 regardless of status or just STAT’s? Our PM and night folks are short-handed and have a large workload! […]

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Mixing Studies

Nov 12 2013

george

Teaching Mixing Studies

Educators face the issue of limited resources, so Medical Laboratory Science schools are able to illustrate only basic coagulation concepts in the student lab. George monitors the MLS Educators’ list, CLSEDUC, and came across this helpful suggestion from Program Director Michele Harms, MS, MLS. Michele gave me permission to reproduce the message and her laboratory procedure, […]

Mixing Studies

Factor VIII Inhibitor?

From Deborah Whetzel, Children’s Hospital of the King’s Daughters, Norfolk, VA: We’ve had a couple patients lately that demonstrated inhibition but their factor VIII results are within normal limits or even elevated. The result values differ 30–40% typically between dilutions but as they’re diluted more, the values go up to 300 or 400%. FVIII values that high […]

Bleeding Disorders

Coag Tests for a Community Hospital

From Meg Harlin, Peninsula Regional Medical Center in Maryland: Our Laboratory will be bringing in new coagulation analyzers from Instrumentation Laboratories, Inc.; TOPS 300, in February, 2014. We currently perform prothrombin time and international normalized ratio (PT/ INR), partial thromboplastin time (APTT, PTT), fibrinogen, and D-dimer. A Few years ago we stopped doing bleeding times, mixing studies and […]

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Anticoagulant Therapy

Oct 3 2013

george

Antibodies to Bovine Thrombin

From Manju Bala, St Christopher’s Hospital for Children. Need help with interpreting a coagulation dilemma. A child, 4 months old, post cardiac surgery, no meds, use of bovine thrombin during surgery with prolonged prothrombin time (PT), 29.9s; partial thromboplastin time (PTT, APTT),107.7s; and thrombin time (TT), 40.4s; no correction on mixing. FII, 25%; FV, 7%, increasing with […]

Coagulation Factors

Positive DRVVT when Mixing Study Corrects

From Aliaa Amer: Hi George, we are using Actin FSL for our routine activated partial thromboplastin time (APTT, PTT). Whenever we get a prolonged APTT that is >5 s above the upper limit of the norm range we do mixing studies, both immediate and 2 h incubation using 1:1 and 4:1 mix, the latter to detect […]

Lupus Anticoagulant

More on “Unexpected DRVVT Results”

Here is a message about the dilute Russell viper venom time assay (DRVVT) for lupus anticoagulant (LA) from international expert Thomas Exner, HAEMATEX, Sydney, Australia: It was a pleasure to meet you at the International Society on Thrombosis and Haemostasis (ISTH) meeting recently. I would like to respond an interesting question raised on July 16, 2013 in your Fritsma Factor website. […]

Lupus Anticoagulant

Lupus Anticoagulant Panel

From Don Wahl, Sanford Health: What are the recommended tests to include in a lupus anticoagulant/antiphospholipid antibody (LA/APL) panel? Is there an antiphospholipid group that gives recommendations? Thank you, Don. Hello, Don, and thank you for your question. The group you need is provided in the title of this reference, and the reference provides the assays that […]

Mixing Studies

PTT Mix Prolonged Beyond Patient PTT

From “Danagah” (originally posted February 23, 2012): Hi, George, have you seen the situation when, in the 1:1 immediate mix of a partial thromboplastin time (PTT) mixing study, the PTT is longer than the patient’s initial PTT? The patient does not appear to be on heparin (data to follow): Patient PTT: 39.0 sec Normal pool: 30.9 sec 1:1 […]

Mixing Studies

Rivaroxaban and LA?

There are three helpful comments appended to our December 5, 2012 Delta Checks for PT, PTT, Fg, and D-dimer post. One came from “goblue,” whom I surmise is aUniversity of Michigan Wolverines fan (sorry about that South Carolina game): “While administering Xarelto (rivaroxaban), will this give a false positive result on lupus anticoagulant (LA) tests?” Yes, as rivaroxaban […]

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Lupus Anticoagulant

Mixing Studies

Mixing Studies 24/7?

Teaching Mixing Studies

Factor VIII Inhibitor?

Coag Tests for a Community Hospital

Antibodies to Bovine Thrombin

Positive DRVVT when Mixing Study Corrects

More on “Unexpected DRVVT Results”

Lupus Anticoagulant Panel

PTT Mix Prolonged Beyond Patient PTT

Rivaroxaban and LA?

George Fritsma MS MLS

Cheat Sheets from George

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